Abstract
Background. Protein-energy wasting, muscle mass (MM) loss and sarcopenia are highly prevalent and associated with poor outcome in haemodialysis (HD) patients. Monitoring of MM and/or muscle metabolism in HD patients is of paramount importance for timely detection of muscle loss and to intervene adequately. In this study we assessed the reliability and reproducibility of a simplified creatinine index (SCI) as a surrogate marker of MM and explored its predictive value on outcome.
Method. We included all in-centre HD patients from 16 European countries with at least one SCI. The baseline period was defined as 30 days before and after the first multifrequency bioimpedance spectroscopy measurement; the subsequent 7 years constituted the follow-up. SCI was calculated by the Canaud equation. Multivariate Cox proportional hazards models were applied to assess the association of SCI with all-cause mortality. Using backward analysis, we explored the trends of SCI before death. Bland-Altman analysis was performed to analyse the agreement between estimated and measured MM.
Results. We included 23 495 HD patients; 3662 were incident. Females and older patients have lower baseline SCI. Higher SCI was associated with a lower risk of mortality [hazard ratio 0.81 (95% confidence interval 0.79-0.82)]. SCI decline accelerated similar to 5-7 months before death. Lean tissue index (LTI) estimated by SCI was correlated with measured LTI in both sexes (males: R-2 = 0.94; females: R-2 = 0.92; both P <0.001). Bland-Altman analysis showed that measured LTI was 4.71 kg/m(2) (62 SD: -12.54-3.12) lower than estimated LTI.
Conclusion. SCI is a simple, easily obtainable and clinically relevant surrogate marker of MM in HD patients.
Original language | English |
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Pages (from-to) | 2161-2171 |
Number of pages | 11 |
Journal | Nephrology Dialysis Transplantation |
Volume | 35 |
Issue number | 12 |
DOIs | |
Publication status | Published - Dec 2020 |
Keywords
- BIOIMPEDANCE
- C-REACTIVE PROTEIN
- INFLAMMATION
- LEAN BODY-MASS
- MALNUTRITION
- MORTALITY
- NUTRITIONAL-STATUS
- SERUM-ALBUMIN
- SURVIVAL
- X-RAY ABSORPTIOMETRY
- creatinine
- haemodialysis
- lean body mass
- muscle mass metabolism
- simplified creatinine index
- TRANSTHYRETIN